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PCMH

New ebook on the ROI of investing in the patient experience

Recently, the check-in automation company Phreesia invited me to write an ebook on one of my favorite topics: the patient-centered practice. It's called "Beyond Five-Star Reviews: Why the Patient Experience Matters, and How to Improve It," and it's available free with registration -- just click on this link. The idea of being more patient-centered and creating a better patient experience attracts more controversy and confusion than it should. The bottom line is that being more patient-centered fits with clinical goals as well as business ones, because it may help patients become more engaged and more receptive to clinical advice. "Patient-centered" is not about chasing positive reviews, and it's not about being patient-led. It's about understanding the patient perspective and communicating that you do, while also maintaining your practice's clinical integrity and mission. And it's about focusing on administrative processes patients interact with every day that can make your practice more or less welcoming and convenient for patients. The ebook contains some ideas that any practice can implement to improve the patient experience. I hope you'll check it out -- download it here.

By |2017-03-27T08:19:14-08:00March 27th, 2017|
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Ready to take the CCM plunge?

As you may know already, I've been working on a series of papers on Medicare's chronic care management reimbursement program (CCM) for the Medical Product Guide. (Click on 'resources' after visiting the Medical Product Guide link if you're interested -- they're free.) Talking to practices that have already started working on CCM, along with others that have held back, has been a learning experience.  The ability to take on CCM quickly depends a lot on your current practice set-up and, especially, your EHR. On the current set-up side, if you're working on or already have set up a medical home (PCMH), and have one or more case managers in place to support it, you may find it easy to use the same staff structure for CCM. Your case managers could become the coordinators for CCM as well -- perhaps personally contacting patients and doing the other care management tasks that contribute to the required 20 minutes per month for billing. Perhaps there will be overlap between the PCMH and CCM that could be beneficial -- if, for example, you're looking at a similar mix of conditions, that might allow for some standardized communications or tracking tools.  Or perhaps you could add a group visit program that would serve patients from both programs. (A group visit program wouldn't contribute to the CCM monthly time requirement, since that's strictly non-face-to-face time, but it still could be well received, and fit with the patient engagement goal of the program.) On the other hand, if your practice hasn't yet taken on PCMH, CCM could be a stepping stone. Many primary care practices believe they're already doing many of the tasks that are meant to be compensated by CCM -- they're just not tracking them, and they haven't had a way to bill for them, either.  That last problem is expressly addressed by CCM -- the key is solving the former problem of tracking. EHR vendors vary dramatically in this area. Some have already created dedicated modules that allow for templates for clinical staff contacts to be tracked, and for the time to be calculated. Others

By |2022-01-01T22:51:58-08:00October 31st, 2015|
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Patient-centered medical homes: what’s behind all the hype? [Power Up webinar series]

A key factor in the patient-centered movement gaining traction is the Affordable Care Act and its intention to improve population health and reduce healthcare costs in the United States. This is expected to be accomplished through improved patient satisfaction, coordination of care and better clinical outcomes. The Patient-Centered Medical Home (PCMH) is viewed as a path to accomplish this and CMS is offering financial incentives to primary care practices that become recognized as a PCMH. The idea of PCMH was developed through a consortium of the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American Osteopathic Association. Together they developed joint principles for the PCMH including the provision that each patient would have their personal physician and their care would be directed by the practice, ensuring care was coordinated and/or integrated as deemed appropriate with an expected level of quality, safety and enhanced access, as well as establishing appropriate payment for these efforts. There is national growth in practices achieving recognition as a PCMH with the front-runner of recognition programs being offered by the National Committee for Quality Assurance. In 2011 NCQA’s standards increased to include guidance on developing chronic care management programs, enhancing patient engagement and improving patient outreach, and aligning with EHR and the new healthcare Meaningful Use criteria. NCQA’s program promotes goals to: Improve the patient experience Recognize clinicians’ efforts Provide confidence for purchaser: value for money spent on quality care CMS led the pack with financial incentives for the PCMH, but other payers have also emerged with bonus and payment systems that recognize the PCMH, improved outcomes and patient satisfaction In 2013 NCQA announced the Patient-Centered Specialty Practice recognition program. The development of this program was motivated by the discovery of reporting discrepancies between referring physicians and specialist. The PCSP program is designed to improve communication and access. Yes, there’s a lot of buzz about the focus on being patient-centered and improving the patient experience, but the programs are only growing in importance. If you haven’t already done so, it’s time to get information, make the commitment

By |2022-01-01T22:52:02-08:00November 17th, 2014|
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The patient-centered specialty practice (how special are you?)

In 2013 NCQA rolled out the Patient-Centered Specialty Practice, PCSP, Recognition Program to distinguish specialists that achieve specific marks with: Developing and maintaining referral agreements and care plans with primary practices; Providing superior access to care (including electronically) when patients need it; Tracking patients over time and across clinical encounters to ensure patient care needs are met; and Providing patient-centered care that includes the patient, and when appropriate, the family or caregivers, in planning and setting goals. The motivation behind the PCSP program began when reporting discrepancies were identified between referring physicians and the specialists they refer to.  For example, referring doctors claimed that between 25 and 50% of time they were unaware if the patients they refer are actually seen by the specialists.   Another discrepancy was the specialist claiming they sent consult reports 80% of the time, but the primary care physicians state they receive this information only 60% of the time. With the PCSPs intent on improving care coordination and communication between specialists and their primary care physician, managing chronic and acute conditions across continuum of care will be better accomplished. The PCSP program also evaluates medication management, test tracking and follow-up and information flow over care transitions. This recognition program is expected to result in a better patient experience and improved outcomes.

By |2014-04-17T18:31:36-08:00April 21st, 2014|
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Small practices: PCMH is not out of reach

The Patient-Centered Medical Home is so much more than just a payment innovation -- it's an idea that appeals for clinical reasons to so many physicians and practice managers, who were already aiming to provide the higher level of care-coordination and patient engagement that is the foundation of the PCMH.  But many small practices we work with have been nervous about the hurdles for certification -- is it too much for a solo or two-physician practice to take on? A recent AAFP blog post offers a wonderful idea for smaller practices daunted by the prospect of tackling the PCHM checklist on their own: form an informal network with other, like-minded practices in your area, and divvy up the research and learning.  What a great solution -- and a great way to expand your connections with other professionals in your community. Read about it here.  

By |2022-01-01T22:52:08-08:00March 24th, 2014|
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